The hospital joins the growing ranks of private fertility clinics in Kansas and Missouri that for varying ethical and legal reasons have excluded single women from their practice.

Some local health care officials and fertility experts are worried that a disturbing trend is developing, one that threatens women's reproductive choices.

"I find it frustrating for women that they don't have choices," said Valerie Montgomery Rice, a physician who is head of the fertility clinic at University of Kansas Hospital. "I respect everyone's policies, but I have some issues with that."

About 15 percent of U.S. women of childbearing age have received infertility services, according to a 1999 national report by the Centers for Disease Control and Prevention. Comparable statistics were unavailable for Kansas and Missouri.

While private physicians perform some reproductive services, such as artificial insemination, only fertility clinics are equipped to carry out the more sophisticated assisted reproductive technology procedures. Such procedures involve the handling of eggs and sperm, as with in vitro fertilization.

Shawnee Mission's program and Reproductive Resource Center of Greater Kansas City in Overland Park serve only heterosexual married couples. No clinic in Kansas other than the University of Kansas Hospital serves single women.

Shawnee Mission officials turned down interview requests. In a statement, Chief Executive Officer Sam Turner said he changed the fertility clinic's policy to align with the Seventh-day Adventist Church's stance on assisted reproduction. The hospital is affiliated with the church.

The church's position: "The ideal is for children to have the benefits of an intact family with a mother and father. For this reason, reproductive services should only be provided within the bounds of the fidelity and permanence of marriage."

Shawnee Mission's clinic is the second Kansas clinic in as many years to opt out of treating single women.

The Center for Reproductive Medicine in Wichita stopped providing similar services to single women in December 2000. Officials there would only say that the physician in charge of the program decided to alter the policy.

At other Kansas and Missouri clinics, various officials said the decision to exclude single women was based on the ethical and legal questions spawned by the technology.

That so many Kansas and Missouri clinics do not serve single women disturbs Rice.

"Should the decision be made for women that they shouldn't become a single mom? Or that a single parent should not be considered an intact household?" she said. "I think the question has to be raised as to who should make these judgments."